Numbers do not have to be fabricated to mislead. They can be technically accurate and still create a false story when “detected” becomes “caused,” “involved” becomes “alone,” and a preliminary suspicion becomes a headline.
This dynamic played out following a May 2026 emergency in Mountainair, New Mexico. Three people died in a home where investigators found fentanyl, para-fluorofentanyl, and methamphetamine, while eighteen first responders later reported symptoms such as nausea, coughing, and dizziness. Although officials said they were working merely “under the assumption” that fentanyl was responsible and noted that most evaluated responders had no symptoms, the event was widely described in headlines as an “apparent fentanyl exposure.”
To a physician or lawyer, “apparent” signals that causation has not been established. To most readers, however, it translates to a definitive cause. When truncated in news feeds, social media, or political speeches, qualifiers disappear, converting an unproven inference into accepted fact. Yet medical toxicologists report that clinically significant poisoning from incidental skin contact is extremely unlikely. Repeating “apparent fentanyl exposure” reinforces the belief that proximity alone is fatal, triggering panic, hazardous-material overreactions, and critical delays in administering CPR or naloxone to someone experiencing an overdose. Toxicologists have outlined safety steps and warned that laws and protocols based on these false beliefs make responders’ jobs harder, not safer.
This conversion of uncertainty into certainty equally plagues national mortality statistics. The International Classification of Diseases (ICD-10) uses T40.4 for “synthetic opioids other than methadone.” Crucially, T40.4 includes pharmaceutical fentanyl, illicitly manufactured fentanyl, fentanyl analogs, and tramadol, without distinguishing prescribed medications from illicit street drugs or establishing that fentanyl acted alone. When federal researchers applied a more conservative calculation to separate these sources, the estimated 2016 prescription-opioid death count fell by 47.3 percent, from 32,445 to 17,087. The mortality count did not drop; rather, a flawed definition was corrected.
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Conflating illicit fentanyl with prescription opioids distorts public policy. When deaths involving illicit supply are misclassified under broad prescription labels, policymakers respond by restricting legitimate medical prescribing, imposing rigid dose or duration limits, scrutinizing clinicians, and pressuring stable patients to taper. In its 2022 prescribing guideline, the Centers for Disease Control and Prevention (CDC) acknowledged that inflexible applications of earlier guidance had contributed to rapid tapers, abrupt discontinuation, patient abandonment, untreated pain, withdrawal, and psychological distress. Meanwhile, needed focus and resources are diverted away from illicit market shifts, fentanyl-contaminated stimulants, naloxone distribution, expanded addiction and mental-health services, and addressing social conditions that fuel dangerous drug use.
Overlapping data categories compound the confusion. A single death involving fentanyl, cocaine, and methamphetamine may be counted in all three drug categories. Although the CDC warns that these categories should not be added together, headlines routinely report that fentanyl “caused” a set number of deaths when data show only that it was involved in the death or detected after death.
Furthermore, underlying drivers like suicide and inadequately treated pain remain largely invisible in official statistics. Because classifying a drug death as intentional requires affirmative evidence (like a note or a documented threat), standard reporting defaults to “accidental” or “undetermined.” Researchers estimated that true suicides may account for 20 to 30 percent of opioid overdose deaths, yet rigid database categories mask this complexity. Similarly, death certificates rarely record chronic pain, involuntary tapering, loss of a prescriber, pharmacy refusal, worsening disability, or a turn to illicit drugs after medical care is disrupted. The absence of these drivers in a database does not erase their existence, and responsible reporting includes acknowledging silent gaps rather than presenting raw mortality data as the complete story.
Sensational law enforcement and media narratives (from claims of officers collapsing upon touch to fears of fentanyl-poisoned Halloween candy or currency) spread because they are frightening. While illicit fentanyl poses genuine dangers, unsubstantiated fear-mongering frightens responders, criminalizes people at overdose scenes, distorts public spending, and penalizes patients while the illicit market rages on.
Journalists and public officials should adopt precise language: “Fentanyl was detected” or “The cause remains under investigation.” They should distinguish illicit from pharmaceutical fentanyl when possible, and state clearly what the available data cannot establish.
Uncertainty is not a flaw to be edited out; it is essential to the truth. When incomplete evidence is reported as certainty, policy targets the wrong people, drugs, and causes, and the reporting error itself fuels the crisis.
Lynn R. Webster is one of the world’s leading authorities on pain management, addiction medicine, and the complex interplay between public policy, misinformation, and human suffering. He is board-certified in anesthesiology, pain medicine, and addiction medicine, a past president of the American Academy of Pain Medicine, and a senior fellow at the Center for U.S. Policy.
He is the author of The Painful Truth: What Chronic Pain Is Really Like and Why It Matters to Each of Us, and coproducer of the PBS documentary of the same name. With Sarah Eichberg, PhD, he is coauthor of Deconstructing Toxic Narratives: Data, Disparities, and a New Path Forward in the Opioid Crisis (Springer Nature, May 28, 2026). A complete list of his titles is available on his books page, and he shares his work on LinkedIn, X, Facebook, and YouTube.
